Offensive Thinking

Brain tumors suck. Hi, I'm Patrick btw. This is my cancer blog. My "normal" stuff is over here.

Radiotherapy Part One: FET-PET Scan

My brain, according to the PET scan
My brain, according to the PET scan

Ok, so here’s my first update on my radiotherapy journey. First of all, despite what I wrote in my last blog post, I will do the therapy in Aachen (where I live) instead of Heidelberg (where my oncologist is). I talked to both the radiologists in Heidelberg and also in Aachen, and the gist of it was: the newer radiotherapy with carbon ions instead of the classic photons mostly benefits patients where the tumor resides in a difficult to access location and where it is imperative not to damage nearby structures (think for example a tumor directly next to the optic nerve), or where the tumor turns out to be resistant to the conventional therapy. It is also a bit less damaging to the surrounding tissue in general, but there are currently no studies proving that the healing chances are better.

So I opted for the easier choice of doing the radiotherapy here in Aachen, where I don’t have to search for accommodations but can simply stay at home, which of course also benefits my wife and daughter. The medical staff here in Aachen is nice and I don’t feel like I’m only making a compromise. The decision was still not easy though, because the treatment in Heidelberg might have some unforseen benefits we don’t know about yet. Also, they have a particle accelerator. Need I say more? ;)

Anyway, the first thing I did here in Aachen (even before the decision to stay for the therapy) was a so-called FET-PET scan. This scan, unlike the usual MRI scans, shows you images of the metabolic activity in the cells. As cancer cells are very active the more malicious they are, it gives you a pretty good picture of what is going on, whereas the MRI scan always has the chance of “false positives”, i.e. you cannot always decide if what you see is a progression of the tumor or other changes.

In my case, it was not strictly necessary to determine if something needs to be done, but more of a helpful scan for planning the radiotherapy better. If you know exactly where the most active cells are, you can then concentrate on those areas.

The FET-PET scan was done at the J├╝lich Research Centre, a secured area where even my daughter needed to have a visitor’s pass (she’s 10 months old now). Although, thinking about it, she is kind of mischievous… I had to lay in an apparatus not unlike a CT scanner, and the whole procedure took close to an hour of laying still, as they were doing multiple scans to see the difference in activity. Good thing I meditate regularly… They also inject you with a tracer that is slightly radioactive, so I was radioactive man for about two hours! No superpowers though, except the need to pee.

Speaking of peeing, fun fact: You are only allowed to use the toilet next to the PET scanner (as in, the bathroom across the hall, not an actual toilet right next to the scanner. That’d be weird). This is because your urine is slightly radioactive after the tracer injection, and being a research center working with radioactive material, they are tightly controlled. Nobody would bat an eye if you pee at home, but in their facilities, you might raise an alarm because radioactive material is released, however small the amount.

The results were nothing surprising, but still nice to see. The activity going on is a little bit above the threshold value where you would say nothing needs to be done, but only barely so. This is on the one hand comforting, as it confirms that there’s no immediate need for action. On the other hand, it makes the decision for taking action not any easier. But I’ve decided to follow through with the radiotherapy, so I’m doing it. Let’s kill those suckers before they can decide to mutate into something faster growing, I say.